Preventing Functional Urinary Incontinence in Hip-Fractured Older Adults Through Patient Education: A Randomized Controlled Trial

Abstract

The purpose of this study was to evaluate whether an educational intervention would reduce the incidence of functional urinary incontinence (UI) in older adults with a fall-related hip fracture. The project was conducted as a multicenter randomized controlled trial (RCT). A total of 109 patients that had been admitted to six hospitals in Castilla-La Mancha (Spain) for acute treatment of hip fracture, previously continent and without cognitive impairment, were enrolled and randomly assigned to the experimental group (EG) or the control group (CG). Intervention (on EG): urinary habit training (Nursing Interventions Classifications taxonomy) was performed during hospital stay (second to fourth postoperative day), with a telephonic reinforcement 10 days after discharge. The CG received routine care. Primary outcome measure: incidence of UI. Follow-up: telephone assessment 3 and 6 months after discharge (blinded evaluation). The incidence of UI at 6 months was 49% (CG) versus 25.5% (EG) (relative risk = 0.52, 95% confidence interval [0.3, 0.9]; number necessary to treat = 4). The mean of UI episodes was 0.54 (EG) versus 1.8 (CG), p = .007. The educational intervention prevents the development of UI and decreases the number of episodes in case of appearance, in a statistically significant way.

Effectiveness of a Standardized Nursing Process Using NANDA International, Nursing Interventions Classification and Nursing Outcome Classification Terminologies: A Systematic Review

“…All the studies showed high or moderate quality following critical reading with CASPe. The studies that showed high quality were the RCT (score 9/11) by Corcoles et al [12], Guerra et al [13], Gencbas et al [14] and Sampaio et al [15]. The remaining studies showed moderate quality in Table S2: Critical reading scores for the included studies.…”

Incidence of urinary incontinence after hip fracture surgery and associated risk factors: a prospective study

“…To our knowledge, only one previous study has prospectively examined the incidence of UI in both men and women after HFS [ 11 ], and almost all data available to date regarding the incidence of UI after HFS in the older population has been obtained from retrospective studies. These have pointed out to an increased prevalence of UI following HF, from 20 to 43% in the first study, published in 1977 [ 14 ], and from 11 to 43% in more recent studies [ 15 , 16 ].…”

“…To our knowledge, studies assessing UI incidence after HFS are scarce, and the prospective ones have not evaluated risk factors potentially associated with developing UI after HFS [ 11 ]. Using log-binomial models including demographic and clinical variables, we found that AUR was associated with an increased risk of UI by two-fold, and UTIs were associated with an increased risk of UI worsening.…”

“…Despite the impact of UI on older individuals and the high incidence of UI in HF patients, no protocols aiming to reduce the incidence of UI after HFS have been established [ 11 ]. However, some interventions have been proven effective in reducing the incidence of UI following HFS [ 11 , 31 ]. Our study indicates that AUR and UTIs should be avoided.…”

“…Despite the existing evidence regarding complications after hip fracture surgery (HFS), it is still unclear how the postoperative process contributes to developing UI or worsening previous UI, and few studies have prospectively assessed UI incidence after HFS [ 11 ]. Given the significant medical, economic, and social impact of this condition on older people [ 12 ], identifying modifiable risk factors for developing UI after HFS can aid in generating clinical protocols for its prevention.…”